Pills and medication for addiction
Introduction
Gambling addiction (ludomania) is traditionally treated with psychotherapy and self-help, but pharmacological methods are also effective with pronounced obsessive impulses to betting. In Australia, three groups of drugs are used: opioid antagonists, antidepressants (SSRIs) and adjuvants (anticonvulsants, N-acetylcysteine). Below is the full review.
1. Opioid antagonists
1. 1 Naltrexone
Mechanism: blocks μ-opioid receptors, reducing the sense of "reward" when betting.
Dosage: 50 mg once a day, up to 100 mg if necessary.
Indications: severe cravings, frequent relapses after psychotherapy.
Side effects: nausea, dizziness, headache; monitoring liver function before prescribing.
1. 2 Nalmefene
Mechanism: Similar to naltrexone but with longer duration and fewer unpleasant effects.
Dosage: 18 mg once daily.
Indications and restrictions: prescribed with an uncontrolled desire to play, requires the supervision of a psychiatrist.
2. Antidepressants (SSRIs)
2. 1 Fluoxetine, sertraline, escitalopram
Mechanism: Increasing serotonin levels stabilizes mood, reduces impulsivity and anxiety.
Dosage: standard - fluoxetine 20-40 mg/day, sertraline 50-100 mg/day, escitalopram 10-20 mg/day.
Indications: concomitant depression or generalized anxiety, intrusive thoughts about rates.
Side effects: insomnia, decreased libido, gastrointestinal disorders; the effect develops after 4-6 weeks.
3. Anticonvulsants and mood stabilizers
3. 1 Topiramate
Mechanism: modulates GABA and glutamate systems, reduces the "impulse to play."
Dosage: start at 25 mg/day, gradually increasing to 100-200 mg/day.
Indications: severe impulsivity, frequent "disruptive" episodes.
Side effects: loss of appetite, memory impairment, paresthesia.
3. 2 Lithium and valproates
Mechanism: stabilization of neuronal activity, prevention of sudden changes in mood.
Indications: when gaming addiction and bipolar spectrum are combined; mandatory monitoring of the level of the drug in the blood.
4. N-acetylcysteine (NAC)
Mechanism: Normalizes glutamatergic transmission, reducing compulsive aspirations.
Dosage: 600-1 200 mg twice a day.
Indications: an auxiliary tool for obsessive gambling thoughts; often combines with psychotherapy.
Side effects: rare - stomach upsets, skin reactions.
5. Treatment regimen and interaction with psychotherapy
1. Specialist assessment
Consultation of a psychiatrist or narcologist: taking a history, PGSI scale, tests for depression (PHQ-9) and anxiety (GAD-7).
2. Combined approach
The simultaneous administration of medications and cognitive behavioral therapy (CBT) accelerates craving reduction and restoration of control.
3. Control and correction
Overestimation of efficacy after 4-6 weeks, dose adjustment or selection of the drug in case of insufficient response.
4. Course duration
At least 6 months, in severe cases - up to a year with a gradual reduction in dose under observation.
6. Contraindications and special recommendations
Liver and kidney disease: Opioid antagonists require prior testing.
Pregnancy and lactation: most drugs are not recommended; discussion of alternatives with a doctor is mandatory.
Concomitant medication: Avoid concomitant use of multiple SSRIs and opioid antagonists without strict control.
Conclusion
Pharmacotherapy for gaming addiction in Australia includes opioid antagonists (naltrexone, nalmefene), antidepressants (SSRIs), mood stabilizers, and adjuvants (topiramate, N-acetylcysteine). The key success factor is the combination of medicines with psychotherapy and regular monitoring of the specialist. Only a comprehensive approach provides a sustainable restoration of control and prevents relapses.
Gambling addiction (ludomania) is traditionally treated with psychotherapy and self-help, but pharmacological methods are also effective with pronounced obsessive impulses to betting. In Australia, three groups of drugs are used: opioid antagonists, antidepressants (SSRIs) and adjuvants (anticonvulsants, N-acetylcysteine). Below is the full review.
1. Opioid antagonists
1. 1 Naltrexone
Mechanism: blocks μ-opioid receptors, reducing the sense of "reward" when betting.
Dosage: 50 mg once a day, up to 100 mg if necessary.
Indications: severe cravings, frequent relapses after psychotherapy.
Side effects: nausea, dizziness, headache; monitoring liver function before prescribing.
1. 2 Nalmefene
Mechanism: Similar to naltrexone but with longer duration and fewer unpleasant effects.
Dosage: 18 mg once daily.
Indications and restrictions: prescribed with an uncontrolled desire to play, requires the supervision of a psychiatrist.
2. Antidepressants (SSRIs)
2. 1 Fluoxetine, sertraline, escitalopram
Mechanism: Increasing serotonin levels stabilizes mood, reduces impulsivity and anxiety.
Dosage: standard - fluoxetine 20-40 mg/day, sertraline 50-100 mg/day, escitalopram 10-20 mg/day.
Indications: concomitant depression or generalized anxiety, intrusive thoughts about rates.
Side effects: insomnia, decreased libido, gastrointestinal disorders; the effect develops after 4-6 weeks.
3. Anticonvulsants and mood stabilizers
3. 1 Topiramate
Mechanism: modulates GABA and glutamate systems, reduces the "impulse to play."
Dosage: start at 25 mg/day, gradually increasing to 100-200 mg/day.
Indications: severe impulsivity, frequent "disruptive" episodes.
Side effects: loss of appetite, memory impairment, paresthesia.
3. 2 Lithium and valproates
Mechanism: stabilization of neuronal activity, prevention of sudden changes in mood.
Indications: when gaming addiction and bipolar spectrum are combined; mandatory monitoring of the level of the drug in the blood.
4. N-acetylcysteine (NAC)
Mechanism: Normalizes glutamatergic transmission, reducing compulsive aspirations.
Dosage: 600-1 200 mg twice a day.
Indications: an auxiliary tool for obsessive gambling thoughts; often combines with psychotherapy.
Side effects: rare - stomach upsets, skin reactions.
5. Treatment regimen and interaction with psychotherapy
1. Specialist assessment
Consultation of a psychiatrist or narcologist: taking a history, PGSI scale, tests for depression (PHQ-9) and anxiety (GAD-7).
2. Combined approach
The simultaneous administration of medications and cognitive behavioral therapy (CBT) accelerates craving reduction and restoration of control.
3. Control and correction
Overestimation of efficacy after 4-6 weeks, dose adjustment or selection of the drug in case of insufficient response.
4. Course duration
At least 6 months, in severe cases - up to a year with a gradual reduction in dose under observation.
6. Contraindications and special recommendations
Liver and kidney disease: Opioid antagonists require prior testing.
Pregnancy and lactation: most drugs are not recommended; discussion of alternatives with a doctor is mandatory.
Concomitant medication: Avoid concomitant use of multiple SSRIs and opioid antagonists without strict control.
Conclusion
Pharmacotherapy for gaming addiction in Australia includes opioid antagonists (naltrexone, nalmefene), antidepressants (SSRIs), mood stabilizers, and adjuvants (topiramate, N-acetylcysteine). The key success factor is the combination of medicines with psychotherapy and regular monitoring of the specialist. Only a comprehensive approach provides a sustainable restoration of control and prevents relapses.
